DOI: https://doi.org/10.14710/jbtr.v10i1.20804

Association between Neutrophil to Lymphocyte Ratio and Post Operative Atrial Fibrillation after Coronary Artery Bypass Graft operation.

Department of Cardiology and Vascular Medicine, Faculty of Medicine Diponegoro University, Semarang, Indonesia, Indonesia

Received: 11 Nov 2023; Accepted: 29 Apr 2024; Available online: 30 Apr 2024; Published: 30 Apr 2024.
Open Access Copyright (c) 2024 Journal of Biomedicine and Translational Research
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

ABSTRACT

 

Background: Post operative atrial fibrillation (POAF) is associated with cardiovascular outcomes such as stroke, heart failure, and mortality. Neutrophil to lymphocyte ratio (NLR) is one of biomarker of inflammation. The use of cor pulmonary bypass(CPB), surgical trauma and reperfusion injury during cardiac surgery causes inflammation. NLR is suspected to be a biomarker that represents the inflammatory response as a modulator of POAF, but data are still lacking.This study analyzed the association between NLR and POAF after coronary artery bypass graft (CABG) operation.

Methods: This was an Observational analytic study, involving patients after the CABG procedure in Kariadi Hospital between June 2022 to September 2023. NLR was assessed in the first three hours after operation. ECG Holter was attained for 96 hours post-CABG procedure.

Results: The total subject was 62 patients, consisting of 57 men and 5 women with a mean age of 58,7 ± 6.39 years. Mean postoperative NLR 4.95 ± 2.17 with a median of 4.56 (1.52-11.00). There was a significant association between post-operative NLR with POAF after CABG (p=0.006, OR 4.64, 95%CI 1.50-14.35). High inotropic dose and β blocker initiation time less than 45 hours correlate significantly with POAF after CABG (p<0.001, OR 6.94 dan p=0.001, OR 0.17).

Conclusions: Postoperative NLR is associated significantly with POAF after CABG.

 

Keywords: Neutrophil to Lymphocyte Ratio, Post Operative Atrial Fibrillation, coronary artery bypass graft, ECG Holter

Note: This article has supplementary file(s).

Fulltext View|Download |  Cover Letter
Cover letter
Subject Cover letter
Type Cover Letter
  Download (75KB)    Indexing metadata
Keywords: Neutrophil to Lymphocyte Ratio, Post Operative Atrial Fibrillation, coronary artery bypass graft, ECG Holter

Article Metrics:

Article Info
Section: Original Research Articles
Language : EN
Recent articles
Association between Neutrophil to Lymphocyte Ratio and Post Operative Atrial Fibrillation after Coronary Artery Bypass Graft operation. The Impact of Butterfly Pea Flower (Clitoria ternatea L.) Extract on Atherosclerosis Biomarker Profiles in Obese White Rats (Rattus norvegicus L.) Effect of Myristica fragrans on PGC1α and Synaptophysin Expression in Male Wistar Rats Hippocampus Squamous Cell Carcinoma Cervical Uterine Metastasis in Abdominal Wall: A Rare Case Report The Influence of CYP2C19 Gene Polymorphism on Selective Serotonin Reuptake Inhibitors In Patients with Major Depressive Disorder: A Pharmacogenetic Prospecting Approach More recent articles
  1. REFERENCES
  2. Gaudino M, Di Franco A, Rong LQ, Piccini J, Mack M. Postoperative atrial fibrillation: from mechanisms to treatment. Eur Heart J. Epub ahead of print 21 March 2023. DOI: 10.1093/eurheartj/ehad019
  3. Hague CW, Creswell LL, Gutterman DD, Fleisher LA. Epidemiology, mechanisms, and risks: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest; 128. Epub ahead of print 2005. DOI: 10.1378/chest.128.2_suppl.9S
  4. Ishii Y, Schuessler RB, Gaynor SL, Yamada K, Fu AS, Boineau JP, et al. Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation. Circulation 2005; 111: 2881–2888
  5. Kalman JM, Munawar M, Howes LG, Louis WJ, Buxton BF, Gutteridge G, et al. Atrial Fibrillation After Coronary Artery Bypass Grafting Is Associated With Sympathetic Activation
  6. Weedle RC, Costa M Da, Veerasingam D, Soo AWS. The use of neutrophil lymphocyte ratio to predict complications post cardiac surgery. Ann Transl Med 2019; 7: 778–778
  7. Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century: Novel Methods and New Insights. Circulation Research 2020; 127: 4–20
  8. Mathew JP. A Multicenter Risk Index for Atrial Fibrillation After Cardiac Surgery. JAMA 2004; 291: 1720
  9. Lee S-H, Kang DR, Uhm J-S, Shim J, Sung J-H, Kim J-Y, et al. New-onset atrial fibrillation predicts long-term newly developed atrial fibrillation after coronary artery bypass graft. Am Heart J 2014; 167: 593-600.e1
  10. Aranki SF, Shaw DP, Adams DH, Rizzo RJ, Couper GS, VanderVliet M, et al. Predictors of Atrial Fibrillation After Coronary Artery Surgery. Circulation 1996; 94: 390–397
  11. Spach MS, Dolber PC. Relating Extracellular Potentials and Their Derivatives to Anisotropic Propagation at a Microscopic Level in Human Cardiac Muscle Evidence for Electrical Uncoupling of Side-to-Side Fiber Connections with Increasing Age, http://circres.ahajournals.org/
  12. Huxley RR, Filion KB, Konety S, Alonso A. Meta-Analysis of Cohort and Case–Control Studies of Type 2 Diabetes Mellitus and Risk of Atrial Fibrillation. Am J Cardiol 2011; 108: 56–62
  13. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of Neutrophil/Lymphocyte Ratio As Predictor of New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. American Journal of Cardiology 2010; 105: 186–191
  14. Nagi HK, Michael SF, Hamed HA, Awadallah FF. Left Atrial Function as a Predictor for Postoperative Atrial Fibrillation. Biomedical and Pharmacology Journal 2023; 16: 165–177
  15. Liu Y, Han J, Liu T, Yang Z, Jiang H, Wang H. The Effects of Diabetes Mellitus in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting. Biomed Res Int; 2016. Epub ahead of print 2016. DOI: 10.1155/2016/4967275
  16. Taha A, Nielsen SJ, Bergfeldt L, Ahlsson A, Friberg L, Björck S, et al. New-onset atrial fibrillation after coronary artery bypass grafting and long-term outcome: A population-based nationwide study from the SWEDEHEART registry. J Am Heart Assoc 2021; 10: 1–9
  17. Zakkar M, Ascione R, James AF, Angelini GD, Suleiman MS. Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery. Pharmacology and Therapeutics 2015; 154: 13–20
  18. Song M, Graubard BI, Rabkin CS, Engels EA. Neutrophil-to-lymphocyte ratio and mortality in the United States general population. Sci Rep 2021; 11: 464
  19. Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to Lymphocyte Ratio: An Emerging Marker of the Relationships between the Immune System and Diseases. International Journal of Molecular Sciences; 23. Epub ahead of print 1 April 2022. DOI: 10.3390/ijms23073636
  20. Kawahito K, Kobayashi E, Ohmori M, Harada K, Kitoh Y, Fujimura A, et al. Enhanced Responsiveness of Circulatory Neutrophils After Cardiopulmonary Bypass: Increased Aggregability and Superoxide Producing Capacity. Artif Organs 2000; 24: 37–42
  21. Calkins H, Tomaselli GF, Morady F. Atrial Fibrillation : Clinical Features, Mechanisms, and Management. In: Lilly LS (ed) Braunwald’s Heart Disease 12th Edition. Philadelphia: Elsevier, 2022, pp. 1272–1287
  22. Jankovičová K, Trojáčková Kudlová M, Koláčková M, Kuneš P, Manďák J, Lonský V, et al. The Effect of Cardiac Surgery on Peripheral Blood Lymphocyte Populations. Acta Medica (Hradec Kralove, Czech Republic) 2008; 51: 25–29

Last update:

No citation recorded.

Last update:

No citation recorded.